High Prevalence of Multidrug- Resistant Klebsiella Pneumoniae in Pediatric Patients: A Retrospective Analysis.

Abstract

Antibiotic-resistant infections in children are a growing clinical concern worldwide. Klebsiella pneumoniae (K.pneumoniae) is a leading cause of hospital-acquired infections and often exhibits multidrug resistance, including extended-spectrum β-lactamase (ESBL) production and carbapenem resistance. This study examines the prevalence of K. pneumoniae in pediatric patients upon hospital admission and characterizes its antibiotic resistance profile.

Objectives: This study aimed to determine its prevalence and resistance patterns in children at hospital admission.

Methods: We conducted a retrospective study of 93 pediatric inpatients admitted to a tertiary children's hospital. Clinical and microbiology records were reviewed to identify patients with K. pneumoniae isolated from admission cultures. Antibiotic susceptibility testing was performed on each K. pneumoniae isolate for a panel of antibiotics spanning penicillins, cephalosporins, carbapenems, aminoglycosides, tetracyclines, and fluoroquinolones. The frequencies of resistance and sensitivity were determined for each antibiotic. Fisher's exact tests and factorial ANOVA were used to assess associations between patient diagnosis and resistance.

Results: Out of 93 pediatric patients, 18 (19.35%) had K. pneumoniae isolated, with 72.2% of strains classified as multidrug-resistant. Resistance was highest to ceftriaxone (50%) and ampicillin (44%). Carbapenems and amikacin remained largely effective.

Conclusion: Nearly one-fifth of children admitted had K. pneumoniae detected on initial cultures, with a majority of these isolates exhibiting multidrug resistance, especially to common cephalosporins and penicillins. The high rate of ceftriaxone resistance suggests a prevalence of ESBL-producing strains. Carbapenems and amikacin remained largely effective, underscoring their importance as empiric or targeted therapies in severe pediatric infections.